Doctor-Patient Relationship

Mamas on Bedrest, How long will you wait to be seen?

October 18th, 2010

Out of the mouths of Babes!

Recently, my 4 year old son had the nerve and self assurance to do what makes most adults only think of doing: he told his physician at his recent office visit that he had been waiting a long time and he didn’t like it. This is how the interaction went.

“Where have you been,” asked my son. “We’ve been waiting a really long time.” (We had actually been waiting over an hour in the exam room to be seen. This after I had rushed to pick up both my children from school, fought traffic, crossed town and hurried from the parking lot-for which we were paying by the 1/2 hour for parking- to be on time for our appointment! And no, our parking ticket was not validated!)

The pediatric orthopedic surgeon was a bit surprised at my son’s direct statement and he tried to make light of the situation.”I got lost in the hallways,” he said chuckling. “I was looking for you!”

“You should have asked for help,” said my son with a very serious expression on his face. “It’s not nice to make your friends wait.”

Out of the mouths of babes!

I sat there watching this interaction, surprised and proud at the same time. My son has yet to be indoctrinated into the ways of our health care system. He doesn’t yet know and/or believe that doctors are supposed to be “revered”, that they are busy and important people and that we patients are to wait for them and accept whatever time they are able to give to us and be grateful for their help. Nope, my son had no such illusions. I had told him that we had a 3:30 appointment with the doctor. We had made special arrangements and allowances to be on time for that appointment. When we arrived, on time,  he expected to be seen at his right away-not one hour later! And when the doctor finally entered our exam room, my son looked him in the eyes, stood his full 41 inches and told the doctor that his tardiness was unacceptable, that he should be sorry that he kept us waiting and that he wanted to go home. In my son’s eyes, he had held up his end of the bargain. The pediatric orthopedic surgeon had not and as far as my son was concerned, the surgeon had missed his opportunity to see him and my son wanted to go home.

Worth the Wait?

We should all have the self assurance of my son. I have heard countless women tell stories of how they have waited as long as 3 hours for a routine OB visit-some lasting as little as 10 minutes. Why do we do this? Why do we put up with such blatant disrespect of ourselves and our time?

When I was pregnant with my son and had an appointment with the perinatologist for a Level  II.  My husband and I arrived on time (actually early) for our 10 am appointment only to find that the perinatologist was 2 1/2 hours behind! My husband and I had both rearranged our schedules, leaving our offices to arrive on time for our appointment. Yet, no one in that office had the forethought to call us and say that the perinatologist had had an emergency and was running late; this despite the fact that between us, the office had 5 phone numbers at which to contact us and that just the day before, we had received a message on our home phone machine reminding us of our appointment and clearly stating that if we were more than 15 minutes late, we would not be seen and would have to reschedule.

My husband and I in our ire approached the receptionist and voiced our frustration. My husband went so far as to say that he was going to bill the perinatologist for his time, approximately $150 an hour. While much of our indignation was leveled on a person powerless to effect any change, it did drive home to everyone in that reception area that the level of service we were receiving was unacceptable.

System in Crisis

Our current health care system is broken to say the least. Reimbursement from insurance companies is so poor that many doctors feel compelled to see far more patients in a day than is really feasible. In her blog post, “Does Your Doctor Practice Conveyor Belt Medicine” Dr. Linda Burke-Galloway voices her concern over learning that some physicians admit to seeing 50-100 patients a day just to make ends meet. A physician herself and now a malpractice expert, Dr. Burke-Galloway knows that when a doctor exceeds 30 patients in a day, quality patient care and safety have gone out the window. Dr. Burke-Galloway has very simple advice for women when choosing providers-Ask how many patients the doctor sees daily. Along with that question, when selecting a provider, Mamas on Bedrest & Beyond suggests that women pose the following questions:

  1. How many patients does the doctor see daily?
  2. What is the average wait time to be seen?
  3. How often is the doctor called away on emergencies?
  4. What type of office coverage (physician assistant, nurse practitioner or partner) does he/she have for emergencies?
  5. I am automatically rescheduled if I am more than 15 minutes late. Does the doctor hold him/herself to this same standard of punctuality?
  6. Will the office call and contact me if the doctor is running behind? Will I have the option to reschedule?

I think that most of us have experienced an excessive wait time at a doctor’s office only to have a “drive by” interaction once the physician actually comes in the room to see us. This is not good health care. This is a recipe for errors, untoward events (i.e. bad outcomes), malpractice, litigation and generally bad feelings all around. Interestingly, we would never put up with such treatment from an auto mechanic, restaurant, or even lawn maintenance companies. So why are physicians treated differently? If we are truly consumers of health care, physicians work for us! If we would not accept such service from other providers why do we do it when it comes to our most important assest, our health?

Many people proclaim that the United States has some of the best health care in the world and it’s very likely that we do. But what good is our highly advanced, technological health care system  if a large portion of our population doesn’t have access to these latest technologies and treatments? What does it matter if we have brilliant doctors if they don’t have the time to actually practice the art of medicine, but must be more concerned about reimbursement from insurance companies so that they can stay afloat and have a practice at all?

I agree with Dr. Burke-Galloway that we patient-consumers are going to have to be the driving force behind health care reform. We are going to have to ask questions of our providers, demand that common courtesies be met and demand that we are treated with respect compassion at each interaction. We must hold insurance companies accountable to reimburse our health care providers in line with the skill and expertise they use to treat patients,  and in a timely fashion. In this way health care providers can not only provide safe and effective health care, but also be able to  maintain a  medical practice and  earning a comfortable living.

Like many areas of our culture, health care is in dynamic flux. The Affordable Care Act has usherd in a new era of health care reform, but unless we consumers voice our need and demands, we are unlikely to see any real reform at the doctor-patient level.

Have you waited an excessive amount of time to see your health care provider only to be given a “drive by” exam? Share your story with us in the comments section. If enough people voice their discontent, surely we’ll be able to effect change.  Thanks! MBB

Photo Courtesy of Todd Bigelow Photography